Evidence increasingly suggests that mental health problems are associated with insults during critical times of brain development, and also by exposures over an individual's life course. These include in-utero exposures, which may lead to subtle neurobehavioral difficulties, and contextual exposures such as neighbourhood quality and quality of child-rearing environment. Much of the work in this area to date has focused on early life determinants of schizophrenia, and to a lesser extent depression and suicide. Further, there is a body of evidence relating birthweight to cognitive function in childhood, though a recent sibling-based analysis suggested that this association was driven by fixed familial factors such as background socioeconomic position and behaviours/exposures that are similar for all siblings within a family. (1)

However, there is relatively little work on the role of early alcohol exposure on the occurrence of a range of cognitive, behavioural and emotional difficulties. Exposure to alcohol consumption in pregnancy is an example of the effects of an exposure during a sensitive period. The teratogenic effects of alcohol causes a variety of adverse developmental outcomes including Foetal Alcohol Syndrome (FAS) and Foetal Alcohol Effects. (2) Whereas consistent excessive drinking in pregnancy is definitely associated with more severe symptoms, the evidence is unclear as to the impact of more moderate drinking exposure on milder forms of developmental outcomes. However concerns remains over the fact that even moderate consumption of alcohol in pregnancy may increase the risk of mild cognitive impairment, ADHD and learning and behavioural difficulties. (2) Finally there is emerging evidence pointing to an association between alcohol and tobacco use in pregnancy and the development of addictive behaviours, such as addiction to alcohol. (3-6)

The mechanisms underlying these associations are unknown. It is assumed that the effects are due to specific intrauterine exposure, but genetic factors and shared familial factors (including socioeconomic position, shared/learnt familiar behaviours) may well explain any link between moderate alcohol consumption in pregnancy and later effects on offspring cognitive function and behaviour. One way to further explore this would be to compare associations of maternal alcohol consumption during pregnancy with offspring outcomes to the same associations with paternal alcohol consumption. To date no previous study has done this.

There are only a handful of studies with the capacity to test the early development of alcohol problems in children. Further evidence is needed to assess whether in-utero exposure to moderate alcohol consumption truly contributes to later developmental problems. If this is so it is also important to understand the mechanisms underlying these associations.

The aim of this proposal is to use ALSPAC data in order to determine whether intra-uterine exposure to alcohol consumption (assessed by maternal self-report of alcohol consumption during pregnancy) is related to poorer cognitive function, academic difficulties, behavioural problems (eg Attention Deficit Hyperactivity Disorders) during the childhood years and addictive behaviours later in adolescence. The association of maternal alcohol consumption during pregnancy with these offspring outcomes will be compared to similar associations with paternal alcohol consumption (based on self-report by the partner of the mother with restriction to those who define themselves as the biological father). This comparison will facilitate our ability to determine whether there is a true intrauterine effect, since if there is one would anticipate associations only with maternal alcohol consumption. Similar association with paternal intake would suggest that genetic factors and/or shared family environmental factors explain the association rather than specific intrauterine effects.